Predictors of Functional Restoration in Extremity Injury Patients
Objective: To examine predictive powers of severity of injury, pain, ability of joint movement and delirium on functional restoration among extremity injury patients.
Design: Descriptive predictive study.
Methodology: The sample consisted of 85 extremity injury patients who had Abbreviated injury scale (AIS) score of 3 or higher, and Glasgow Coma Scale of 15. The patients were being treated at a selected hospital. The instruments used for data collection were a severity of injury assessment form, Short-form McGill Pain Questionnaire (Th-SFMPQ), degree of joint movement ability record form, Thai Delirium Rating Scale-Ramathibodi Hospital (TDRS-RH) Questionnaire, and Functional Restoration of Cumulate Ambulation Score (CAS) Questionnaire. Data were analyzed using Logistic regression, with the signifcant value set at 0.05.
Results: More than half of the participants (64.7%) were male, with an average age of 50.54 years (SD = 19.60), a moderate level of injury severity ( = 14.89±8.914) and a moderate ability of joint movement ( = 3.35±4.17). The top three organs with abnormal joint movements were the hips, the knees, and the ankles, respectively. The participants' average total pain score was 10.13 (SD = 7.48). Acute delirium was found in only three
participants. Most participants reported good functional restoration ( = 1.79±0.41). Only the severity of injury (OR = 3.326; 95%CI = 1.353-8.176, p < 0.001) and ability of joint movement (OR = 1.440; 95%CI = 1.139-1.821, p < 0.001) were able to jointly predict functional restoration for 64.7% of variance (R2 = .647, Chi square = 45.768, p < 0.001).
Recommendations: The fndings indicated that severity of injury and ability of joint movement inﬂuenced functional restoration in extremity injury patients. Therefore, physical rehabilitation must be a priority in patients with high injury severity level and abnormal joint movement, in order to promote recovery of functional restoration, and prevent possible complications caused by decreased joint movement.
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